June 28, 2016, 11:47 am

Citrate Salt Of Sildenafil

Citrate salt of sildenafil It didn’t take long for Doctor Throwafit to realize he had some ‘splainin’ to do.

Citrate salt of sildenafil You don’t tug on Superman’s cape, citrate salt of sildenafil

Citrate salt of sildenafil You don’t spit into the wind…

Citrate salt of sildenafil And you don’t ever, citrate salt of sildenafil EVER mess with the nurses in the emergency department!

Citrate salt of sildenafil Srsly.

*****

Oh my god. Citrate salt of sildenafil I need a long vacation.

I am sitting here in Starbucks for the first time in months – I can’t even remember the last time I blogged over coffee – and their microwave kept alarming. Citrate salt of sildenafil I got out of my chair to go check the alarm!

Yeah, citrate salt of sildenafil my nerves are on edge. Citrate salt of sildenafil They are playing this finger-snapping Vegas-jazz stuff over the speakers that has me buzzing like my finger is in a socket. Citrate salt of sildenafil Hey, citrate salt of sildenafil guys, citrate salt of sildenafil what does a girl gotta do for a little Motown ’round these parts?

*****

Citrate salt of sildenafil Ah, citrate salt of sildenafil but there is a silver lining on the horizon!

Citrate salt of sildenafil I am looking forward to attending the ENA Leadership Conference in Portland, citrate salt of sildenafil Oregon in just a couple of weeks, citrate salt of sildenafil which I will cover here at Emergiblog. Citrate salt of sildenafil The link will take you to the live blog for the event.

Citrate salt of sildenafil The ENA always puts on stunning programs – literally “attend today, citrate salt of sildenafil use in practice tomorrow” information. Citrate salt of sildenafil You don’t have to be a manager to attend the Leadership Conference, citrate salt of sildenafil either. Citrate salt of sildenafil All nurses are leaders, citrate salt of sildenafil and there is more than enough in this conference for every nurse, citrate salt of sildenafil from newbie to veteran.

*****

The department is chaotic.

Every bed full.

The hallways are impacted.

With patients. Citrate salt of sildenafil Family members. Citrate salt of sildenafil Lab techs. Citrate salt of sildenafil Portable xray machines and those who wield them.

Three ambulances waiting to give report.

Administrators.

What the hell do they want?

Doctors. Citrate salt of sildenafil Hospitalists. Citrate salt of sildenafil Cardiologists. Citrate salt of sildenafil Intensivists. Citrate salt of sildenafil A rare primary physician who admits their own patients.

Surgeons.

Who want everything….STAT.

Even though nothing about their patients require STAT.

Somewhere in there is the ER physician. Citrate salt of sildenafil And the PA.

We’re on divert, citrate salt of sildenafil except no one told the three ambulances.

Waiting.

No place to sit.

No place to chart.

No place to stand.

*****

And in the middle of all this…

In the middle of this bedlam.

Comes the order.

To give the first dose all the prescribed medications to the ambulatory, citrate salt of sildenafil playing, citrate salt of sildenafil giggling child with otitis media, citrate salt of sildenafil who is with a totally ambulatory, citrate salt of sildenafil fully functional, citrate salt of sildenafil totally-capable-of-going-to-the-pharmacy-and-starting-the-medication-at-home adult parent.

So what, citrate salt of sildenafil you say?

Well, citrate salt of sildenafil this means that instead of being able to discharge this ambulatory, citrate salt of sildenafil capable parent with discharge instructions and a prescription right then and there, citrate salt of sildenafil the RN must now engage in the preparation and administration of a pediatric medication.

Which means:

  • Going to the Pyxis and removing the medications, citrate salt of sildenafil say Tylenol and Zithromax, citrate salt of sildenafil from the machine.
  • Because the Hilton Hospital has no Pharmacy at night, citrate salt of sildenafil the Zithromax must be reconstituted by the RN – yep, citrate salt of sildenafil we measure it, citrate salt of sildenafil we mix it, citrate salt of sildenafil we shake it, citrate salt of sildenafil we pour it.
  • Calculating the appropriate dose based on the child’s weight (yes, citrate salt of sildenafil we have to do that, citrate salt of sildenafil even if the doctor has written a dose).
  • Pour the meds, citrate salt of sildenafil draw them up into a dosing syringe.

Citrate salt of sildenafil No biggie so far? Remember all the hell going on in the rest of the department? One nurse is tied up doing this totally unnecessary function. Citrate salt of sildenafil But it gets better because…

Citrate salt of sildenafil They have decided that decades of nursing experience is not enough to ensure appropriate safeguards in pediatric medication administration so…

  • A second nurse has to calculate and double check everything the first nurse has done and sign off on the calculations before the medication is given.

Citrate salt of sildenafil And there you have it! Two nurses taken from much more critical work to make sure ambulatory, citrate salt of sildenafil playing, citrate salt of sildenafil giggling child with otitis media gets their first dose of medication, citrate salt of sildenafil when there is no reason on God’s green earth Mommy and Daddy cannot go get the medication and start it themselves.

Citrate salt of sildenafil And why?

Citrate salt of sildenafil Because it all has to do with patient satisfaction!

If we don’t do this, citrate salt of sildenafil they don’t think we treated their child. Citrate salt of sildenafil And gosh, citrate salt of sildenafil it’s the middle of the night and who wants to wait with a tired kid at the pharmacy and what if the pharmacist is on break and what if they don’t have the cash and what if the ATM machine is broken and…..

EEEEEEEEEEEENOUGH!!!!!!!!

Seriously, citrate salt of sildenafil people, citrate salt of sildenafil this is the minutiae that we have to deal with.

I want to take good care of my patients, citrate salt of sildenafil I really do. Citrate salt of sildenafil I like my patients, citrate salt of sildenafil I want to make their stay in the ER easier and more comfortable and as pain free as I can possibly make it.

I’m a good nurse. Citrate salt of sildenafil No. Citrate salt of sildenafil I’m a damn, citrate salt of sildenafil excellent nurse.

But this bullshit is killing me.

Killing me.

Oh, citrate salt of sildenafil and someday, citrate salt of sildenafil let’s go out and have a drink and I’ll tell you about the time I got the order to irrigate my patient’s ears. Citrate salt of sildenafil In fact, citrate salt of sildenafil it was on the same night. Citrate salt of sildenafil She was having a bit of trouble hearing, citrate salt of sildenafil you see. Citrate salt of sildenafil Berated me because I wasn’t doing it fast enough. Citrate salt of sildenafil She didn’t care that hypotension and a cath lab patient trumped ear wax.

Yeah, citrate salt of sildenafil I definitely need a margarita to tell that one…..

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3 Comments

  • deedoyle
    deedoyle

    February 4, 2011 at 3:33 am

    The trials of the ER nurse, and any urgent care nurse are many. My sympathy and empathy to those who trudge daily through the maze to give the best possible patient care possible.
    Dr. Pamela Wible speaks on community-based patient-centered care at the One Path Summit in Atlanta this March 26-27. Along with 7 of her peers, Dr. Wible will join in discussions on traditional and complementary medical practices.
    For more info go to http://www.onepathsummit.com.


  • John
    John

    February 4, 2011 at 4:57 am

    Oh , My sympathy is with you. Don’t feel low. I’m sure you will get something to learn from such kind of experiences too


  • TD
    TD

    February 4, 2011 at 3:23 pm

    As an ER doc, I totally share your frustration. Our job is not to make patients happy. Our job is to make them better.

    If they wind up happy because we’ve made them better, then that is great. However, patient satisfaction is not my goal. My goal is to provide good care.

    Unfortunately, patient satisfaction is becoming more and more of a forced issue. Many ER groups are starting to use patient satisfaction ratings as a factor in determining the physicians’ pay.

    Talk about a conflict of interests!

    myerlife.com


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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